A Holistic Approach to Cardiac Care – Integrative Cardiology Prevention, Early Detection, Treatment and Rehabilitation

Author(s): 

Rauni Prittinen King, RN, BSN, HNC, CHTPI
Founder and Director of Programs and Planning
Scripps Center for Integrative Medicine
San Diego, California

Cardiovascular disease remains the leading cause of morbidity and mortality in the United States. According to the American Heart Association, every 30 seconds, an American dies of cardiovascular disease. The statistics for women are more staggering than that for men. What can we do to improve these statistics?

Scripps is well known for excellence in the treatment of cardiovascular disease. Scripps Center for Integrative Medicine offers sophisticated prevention, diagnostic testing and treatment programs that are personalized for each patient. This is a place where people come to find healing for body, mind and spirit. The Center is part of Scripps Health, with 5 hospital campuses throughout San Diego County.

The center is located at Scripps Clinic on the Scripps Green Hospital campus, which is home to 350 multi-specialty physicians and is world-renowned for interventional cardiology and research. Overlooking the Pacific Ocean, the Integrative Medicine Center is known for its high-tech – high-touch approach to cardiac care. The Dickinson & Gooding Early Detection Center (EDC) with its unique healing environment complements the center’s full range of advanced diagnostic testing, including the state-of-the-art 64-slice PET/CT scanner and a nuclear medicine SPECT/CT scanner. All diagnotic imaging modalities at the EDC have American College of Radiology accreditation, including nuclear cardiac imaging. Interpretations of the examinations are performed by board-certified physicians in cardiology, radiology and nuclear medicine. Stress testing and nuclear cardiac imaging are performed in this newly built diagnostic lab.

Based on well-documented environmental research linking a person’s physiological wellness with an innate need for nature, the center’s architecture was designed to elicit a calm, peaceful state of mind. This has been largely achieved by using as its template the Golden Mean, a natural, sacred geometric proportion that is the basis of the center’s structure and interior design. The spiral, nature and sacred geometry are reflected in nearly every design aspect of the center, from the generous use of curved spaces, natural light and variations in ceiling height to the application forms, textures, patterns and colors borrowed from earth, water and sky.

Four cardiologists, two nurse practitioners, nurses, medical assistants, nutritionists, exercise physiologists and radiology technicians provide comprehensive, full-spectrum care at the Early Detection Center. Patients are screened for genetic risk factors for heart disease and assessed hemodynamically. They then receive advanced lipid testing and management. When it is indicated, non-invasive CT angiography, coronary calcium screening or rubidium PET imaging to assess myocardial perfusion and viability is performed. A comprehensive program is created for each patient, including nutrition and exercise recommendations, and the appropriate use of medication and nutriceuticals. All recommended herbal supplements are supervised by the registered pharmacists in our herbal pharmacy.

The Scripps Center for Integrative Medicine blends outstanding medical care with evidence-based complementary therapies to support health and healing. The Scripps center model is based on a physician practice group, individual services, programs, education and research. All patients at the center are evaluated by a physician and then a personalized treatment program for nutrition, exercise, medicine and nutriceuticals is developed based on each person’s health care needs and goals.

A variety of complementary therapies, such as biofeedback, acupuncture, healing touch, guided imagery and massage are provided at the center. Patients routinely meet with nutrition counselors and spend time in stress management classes.

If patients need more invasive procedures, such as coronary stenting, they will be treated at the adjacent Scripps Clinic and Scripps Green Hospital. The integrative outpatient clinic model and various healing services work hand-in-hand with conventional care, which is often referred to as the high tech-high touch approach.

Some patients are referred for coronary artery bypass surgery. This is extremely stressful for patients as well as their loved ones, as patients are often not only in a physical crisis but also in an emotional, mental and spiritual crisis. The holistic approach to patient care supports patients beyond their physical needs.

Our protocol for open-heart surgery patients is to have an integrative service coordinator, also a nurse, provide healing touch. She also provides patients with guided imagery CDs to prepare them psychologically and emotionally for their upcoming surgery. When the patient returns to the intensive care unit after surgery, they receive another healing touch treatment and a guided imagery CD which focuses on pain management. The integrative service coordinator then follows the patient along with the cardiac surgery team until discharge.

The integrative service coordinator also teaches cardiac discharge classes and encourages patients to enroll into our cardiac rehab program, called Healing Hearts. This 12-week comprehensive lifestyle change program is medically managed by a cardiologist and nurse practitioner. Cardiac patients are evaluated by a multi-disciplinary team that is coordinated by a nurse case manager. The program participants receive individual consultations by a physician, nurse practitioner, registered dietitian, exercise physiologist and psychologist. Participants attend support group, mindful yoga, meditation and visualization classes. They also attend music therapy, spirituality classes, vegetarian cooking school and an educational lecture series on various health and healing topics. Finally, the cardiac rehabilitation patient exercises with telemetry monitoring under medical supervision in the adjacent fitness center.

Scripps Center for Integrative Medicine’s vision is: Healing People and Changing Lives Through Science and Compassion. Throughout the years and hundreds of heart patients later, we can say that heart disease is preventable. Broken hearts can be healed, and lives can be transformed with a unique combination of allopathic medicine, lifestyle change, complementary modalities and tender loving care.

The author can be contacted at King.rauni@scrippshealth.org

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